Implementing multimodal pain rehabilitation in primary care – a health care professional perspective

Abstract

Purpose: To explore professional perspectives on how to start and work with multimodal pain rehabilitation within primary healthcare.

Methods: Fourteen healthcare professionals (11 women, 3 men) were individually interviewed about their experiences of starting and working with multimodal pain. Interviews were transcribed and analyzed by qualitative content analysis. This study was part of a larger project, which aimed at evaluating multimodal pain rehabilitation in primary care.

Results: The analysis resulted in six categories. Two categories were about management engagement: putting the focus on rehabilitation and creating appropriate conditions. Three were about professional engagement: importance of driving spirits, creating a program – a process, and good teamwork – not a coincidence. The last category was about professional gain from multimodal rehabilitation (MMR): team work is enriching.

Conclusions: To enable implementation of MMR in primary care, managers on all organizational levels must take responsibility for allowing rehabilitation to be a priority. A driving spirit among the professionals facilitates the start, but the entire team is important when processing a program. Creating good teamwork requires hard work, e.g., negotiations for consensus about rehabilitation, and assumption of responsibility by each team member. Collaboration between professionals was perceived to strengthen and enhance knowledge about the patients.

Implications for rehabilitation

• Much can be gained from conducting multimodal pain rehabilitation in primary care.

• Front line managers and those at other organizational levels must prioritize and create appropriate conditions to facilitate multimodal pain rehabilitation in primary care.

• Creation of an effective multimodal rehabilitation team requires that each team member takes responsibility, drops the focus on individual rehabilitation, seek member consensus about the content of the rehabilitation, and confer equal worth to each team member.

• The process of creating a program can be facilitated, especially at the beginning, if the team is supported by speciality pain clinics or more experienced teams.

Keywords:

• Pain; primary care
• implementation
• multimodal rehabilitation
• qualitative
• guidelines

Acknowledgements

We would like to thank the healthcare professionals who shared their rich stories and Elisabeth Pietilä-Holmner who contributed in the data analysis.

Disclosure statement

The authors report no declarations of interest. The Swedish Social Insurance Agency supported this study through the research program, REHSAM.